Q: How can our team prepare for potential productivity losses post-ICD-10 implementation, specifically regarding procedure codes? Should we consider hiring additional staff or staff with a surgical background?
A: The shift to ICD-10 will affect coding and clinical documentation improvement (CDI) productivity, primarily due to the technical features of PCS. Using surgical templates for high-volume procedures can make the transition to PCS easier. These templates could ask the surgeon to identify devices, grafts, and other qualifying information [that CDI and coders need to document to the highest specificity]. For example, was the stent bare metal or drug-eluting? Or was cement used for the arthroplasty?
I do not think we need surgical experience to help us with the PCS coding, as knowledge of anatomy and physiology should suffice. I have found that the extremely granular requirements of PCS coding can make proper MS-DRG assignment challenging in certain situations. This factor will impact CDI and coding DRG-match efforts.
I think the most pertinent value and mission for CDI professionals is accurate documentation of diagnoses, but we can selectively query for some PCS procedures.
Editor’s note: Paul Evans, RHIA, CCS, CCS-P, CCDS, manager of Regional Clinical Documentation & Coding Integrity at Sutter West Bay in San Francisco, answered this question on the ACDIS website. Contact him at evanspx@sutterhealth.org.
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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